Kermit L. Dugger, FNP, PMHNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000007383 Issued in TN

Practice address

1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895

Phone

(423) 542-8929

Fax

(423) 542-8621

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Cardiovascular Disease Physician
  • Marion, VA
  • NPI 1326159567
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Kingsport, TN
  • NPI 1982882379
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1043370687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 W ELK AVE",
            "address_2": "SUITE 11",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432895",
            "telephone_number": "423-542-8929",
            "fax_number": "423-542-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 W ELK AVE",
            "address_2": "SUITE 11",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432895",
            "telephone_number": "423-542-8929",
            "fax_number": "423-542-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGGER",
        "first_name": "KERMIT",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169795",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000007383",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "7383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043370687",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3343836",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr. Benjamin D. Parrish and Assoc OD. PC
• Dr. Nathan Emmert Vision and Eyecare
• Cheyenne L Drew, FNP-C
• Lee Duckworth
• Keith Dugger
• Chase Duty, BS
• Kendal Fox Eden, AUD
• Rebekah Christine Edens, RN
• Lane Evan Edmonds
• Katrina D Edwards, FNP

• Family Nurse Practitioner in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.